Kidney Biopsy: An Experience from Tertiary Hospital

  • Madhav Ghimire College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
  • Bishnu Pahari College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
  • Navaraj Paudel College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
  • Gayatri Das College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
  • Gopal Chandra Das College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
  • Sanjib Kumar Sharma College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan

Abstract

Introduction: Kidney Biopsy is an important diagnostic tool in Nephrology. It is useful in Nephrology in terms of diagnosis, prognosis and management. There is little information on renal biopsy data from central Nepal. We describe our center`s experience in kidney biopsy in term of histological patterns, complications and outcomes.

Methods: We prospectively analyzed the biopsies data of patients over a period of one and half year. All kinds of kidney disease patients were included for kidney biopsy, irrespective of their clinical syndromes and underlying diagnosis.

Results: A total of 75 biopsies were analyzed. Majority of them were females; 56% (n=42). Most of the biopsies; 84% (n=63) were from younger subjects ≤ 45 years and majority of them fell in the age group 11-20 years. Most common clinical renal syndrome to undergo biopsy was Sub Nephrotic range Proteinuria in 53.3% (n=40). Among comorbid conditions, 53.3% (n=40) had Hypertension. The most common histological pattern seen was Mesangial proliferative Glomerulonephritis (MesPGN) seen in 24% (n=18). Among complications associated with the procedure, macroscopic hematuria was seen in 6.7% (n=5) cases and clinically significant perinephric hematoma causing pain was seen in 5.3% (n=4). There was no mortality associated with biopsy procedure.

Conclusions: Sub Nephrotic range Proteinuria was the commonest clinical renal Syndrome observed. In terms of renal histology, Mesangial Proliferative Glomerulonephritis (MesPGN) was the commonest histological pattern observed. Kidney biopsy is a safe procedure without any significant adverse events.

Keywords: Kidney biopsy, sub nephrotic range proteinuria, mesangial proliferative glomerulonephritis

Author Biography

Madhav Ghimire, College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan

Assistant Professor

Department of Nephrology

References

1.Tompson CRV. Indications for renal biopsy in chronic kidney disease. Clinical Medicine. 2003; 3:513-6.

2.Pesce F, Schena FP. Worldwide distribution of glomerular diseases: the role of renal biopsy registries. Nephrol Dial Transplant. 2010; 25: 334-6.

3.Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol. 2004; 15:142-7.

4.Rychlik I, Jancov´a E, Tesar V et al. The Czech registry of renal biopsies. Occurrence of renal diseases in the years 1994–2000. Nephrol Dial Transplant 2004; 19: 3040-9.

5.Naumovic R, Pavlovic S, Stojkovic D et al. Renal biopsy registry from a single center in Serbia: 20 years of experience. Nephrol Dial Transplant. 2009; 24: 877-885.

6.Schena FP. Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. The Italian Group of Renal Immunopathology. Nephrol Dial Transplant. 1997; 12: 418-26.

7.Simon P, Ramee MP, Boulahrouz R et al. Epidemiologic data of primary glomerular diseases in western France. Kidney Int. 2004; 66: 905-8.

8.Covic A, Schiller A, Volovat C et al. Epidemiology of renal disease in Romania: a 10 year review of two regional renal biopsy databases. Nephrol Dial Transplant. 2005; 21: 419-24.

9.Chang JH, Kim DK, Kim HW. Changing prevalence of glomerular diseases in Korean adults: a review of 20 years of experience. Nephrol Dial Transplant. 2009; 24: 2406-10.

10.Research Group on Progressive Chronic Renal Disease. Nationwide and long-term survey of primary glomerulonephritis in Japan as observed in 1850 biopsied cases. Nephron. 1999; 82: 205-13.

11.Barsoum RS, Francis MR. Spectrum of Glomerulonephritis in Egypt. Saudi J Kidney Dis Transplant. 2000; 11:421-9.

12.Wahbeh AM, Ewais MH, Elsharif ME. Spectrum of glomerulonephritis in adult Jordanians at Jordan university hospital. Saudi J Kidney Dis Transplant. 2008; 19(6):997-1000.

13.Yahya TM, Pingle A, Boobes Y et al. Analysis of 490 kidney biopsies data from the United Arab Emirates Renal disease registry. J Nephrol. 1998; 11:148-50.

14.Abdou N, Boucar D, Fary KA et al. Histopathological Profile of Nephropathy in Senegal. Saudi J Kidney Dis Transplant. 2003; 14(2): 212-4.

15.Polito MG, de Moura LA, Kirsztajn GM. An overview on frequency of renal biopsy diagnosis in Brazil: clinical and pathological patterns based on 9617 native kidney biopsies. Nephrol Dial Transplant. 2010; 24: 3050-4.

16.Zhou F, Zhao M, Zou W et al. The changing spectrum of primary glomerular disease within 15 years: A survey of 3331 patients in a single Chinese center. Nephrology Dialysis Transplantation. 2009; 24(3): 870-6.

17.Li LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. Kidney Int. 2004; 66: 920-3.

18.Briganti EM, Dowling J, Finlay M et al. The incidence of biopsy proven glomerulonephritis in Australia. Nephrol Dial Transplant. 2001; 16: 1364-7.

19.Swaminathan S, Leung N, Lager DJ et al. Changing incidence of glomerular disease in Olmsted County, Minnesota: a 30-year renal biopsy study. Clin J Am Soc Nephrol. 2006; 1: 483-7.

20.Rivera F, López-Gómez JM, Pérez-García R. Frequency of renal pathology in Spain 1994-1999. Nephrol Dial Transplant. 2002; 17: 1594-1602.

21.Razukeviciene L, Kuzminskis V, Bumblyte IA et al. The indications of renal biopsies and spectrum of renal disease in five nephrological centers of Lithuania (a five year study). Medicina (Kaunas). 2003; 39: 1-8.

22.Aryal G and RK Kafle. Histopathological spectrum of glomerular disease in Nepal: a seven-year retrospective study. Nepal Med Coll J. 2008; 10(2): 126-8.

23.Malafronte P, Mastroianni-Kirsztajn G, Betônico GN et al. Paulista Registry of glomerulonephritis: 5-year data report. Nephrol Dial Transplant. 2006; 21: 3098-105.

24.Chandrika BK. Non-neoplastic renal diseases in Kerala, India- analysis of 1592 cases, a two year retrospective study. Indian J Pathol Microbiol. 2007; 50: 300-2.

25.Al Arrayed A, George SM, Malik AK et al. Renal biopsy findings in the kingdom of Bahrain: a 13-year retrospective Study. Saudi J Kidney Dis Transpl. 2004; 15: 503-7.

26.Batiniæ D, Sæukanec-Spoljar M, Miloseviæ D et al. Clinical and histopathological characteristics of biopsy-proven renal diseases in Croatia. Acta Med Croatica. 2007; 61: 361-4.

27.Khalifa EH, Kaballo BG, Suleiman SM, Khalil EA, El-Hassan AM. Pattern of glomerulonephritis in Sudan: histopathological and immunofluorescence study. Saudi J Kidney Dis Transpl. 2004; 15:176-9.

28.Sharples PM, Poulton J, White RH. Steroid responsive nephrotic syndrome is more common in Asians. Arch Dis Child. 1985; 60: 1014-7.

29.Choi IJ, Jeong HJ, Han DS et al. An analysis of 4,514 cases of renal biopsy in Korea. Yonsei Med J. 2001; 42: 247-54.

30.Parichatikanond P, Chawanasuntorapoj R, Shayakul C et al. An analysis of 3,555 cases of renal biopsy in Thailand. J Med Assoc Thai. 2006; 89(2):S106-11.

31.Polenakovic MH, Grcevska L, Dzikova S. The incidence of biopsy-proven primary glomerulonephritis in the Republic of Macedonia-long-term follow-up. Nephrol Dial Transplant. 2003; 18(5):v26-7.

32.Huraib S, Al Khader A, Shaheen FA et al. The spectrum of glomerulonephritis in Saudi Arabia: the results of the Saudi Registry. Saudi J Kidney Dis Transpl. 2000; 11: 434-41.
Published
2014-03-31
How to Cite
Ghimire, M., Pahari, B., Paudel, N., Das, G., Das, G., & Sharma, S. (2014). Kidney Biopsy: An Experience from Tertiary Hospital. Journal of Nepal Medical Association, 52(193), 707-712. https://doi.org/10.31729/jnma.2192
Section
Original Article